of the data in ambulatory assessment
• Assessment issues. Collecting
data in the natural environment
presents some unique challenges. As
mentioned previously, an investigator
may collect data that require a response
by the investigator (in case of danger to
oneself or others, for example), but the
investigator may not be made aware of
these responses in real time, or may not
be accessing the data at certain times
of day or evening. One way to address
this challenge is to program immediate
alerts to inform designated “covering”
staff in real time so that interventions
or responses can be made in a timely
manner. Another issue that may arise
involves the collection of biological data.
For example, what are the investigator’s
responsibilities if adverse physiological
events or health conditions are detected,
such as heart arrhythmias? Researchers
should consider these issues before
beginning the study, and should put
in place protocols to handle such
situations. Finally, researchers should
adopt protections for privacy and
confidentiality, as noted previously,
so that study participants are not in
jeopardy of losing services to which they
are entitled, such as health insurance.
• Treatment and intervention
issues. With the widespread adoption
of smartphones and tablets, we have
seen an explosion of apps purporting
to address such mental health issues
as depression, anxiety, problematic
drinking, problematic eating and more.
Although there is great promise in this
line of intervention (sometimes called
ecological momentary interventions,
just-in-time interventions or mHealth
interventions), there is little empirical
evidence for the efficacy of these
interventions administered in daily life
(see Kaplan & Stone, 2013). To date,
there has been almost no oversight
in the development of these daily
life interventions from scientific or
professional organizations. Furthermore,
it is sobering that many of these are not
clearly based on principles of behavior
change, but rather are developed to
look “face efficacious.” The question
also arises of whether the use of apps
for daily life intervention in some way
represents an electronic form of the
independent practice of psychology.
That is, what kind of “supervision” is
necessary for these interventions, if any?
Clearly, the field of psychology needs to
attend to this proliferation of apps that
may serve to confuse and mislead those
seeking mental health services. n
Timothy J. Trull, PhD, is a professor of
psychological sciences at the University of
• Heron, K. E., & Smyth, J. M. (2010). Ecological momentary interventions:
Incorporating mobile technology into psychosocial and health behaviour
treatments. British Journal of Health Psychology, 15, 1–39.
• Kaplan, R. M., & Stone, A. A. (2013). Bringing the laboratory and clinic
to the community: Mobile technologies for health promotion and disease
prevention. Annual Review of Psychology, 64, 471–498.
• Mehl, M. R., & Conner, T. S. (2012). Handbook of research methods for
studying daily life. New York: Guilford.
• Shiffman, S., Stone, A. A., & Hufford, M. R. (2008). Ecological momentary
assessment. Annual Review of Clinical Psychology, 4, 1–32.
• Stone, A. A., & Shiffman, S. (1994). Ecological momentary assessment in
behavioral medicine. Annals of Behavioral Medicine, 16, 199–202.
• Trull, T. J., & Ebner-Priemer, U. W. (2013). Ambulatory assessment. Annual
Review of Clinical Psychology, 9, 151–176.
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